Monday, August 29, 2011

Blue Shield Ordered to Pay For Anorexia Nervosa

A federal appeals court has ruled that BlueShield of California has to pay for a woman's 10-month residential treatment for anorexia nervosa, the Los Angeles Times reported August 29. The insurer had denied such coverage for the woman. Yet under California's Mental Health Parity Act, insurance plans must provide coverage of all medically necessary treatment for nine severe mental illnesses, including eating disorders, the court said.

BlueShield of California's denial also illustrates a persistent problem--that in spite of the national parity law, some insurers continue to deny equitable coverage for treatment of psychiatric conditions. As a result, APA and other groups are trying to get federal officials to release final regulations regarding the parity law. They believe that final regulations will help solve the problem.

As to whether medical treatment for anorexia nervosa is cost-effective in the first place, ample evidence shows that this is in fact the case. For example, a large 2007 study found that over two-thirds of women with anorexia nervosa made a clinical recovery and usually progressed to full recovery during the next five years. For more information about this study, see the American Journal of Psychiatry at http://ajp.psychiatryonline.org/cgi/content/abstract/164/8/1259?maxtoshow.

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